探讨XperCT技术在恶性梗阻性黄疸经皮肝穿刺胆道引流术（percutaneous transphepatic cholangial drainage，PTCD）中提高手术精确性的临床应用价值。

选择我院2018年10月至2019年10月期间恶性梗阻性黄疸87例，按照随机数字表法将87例患者分为两组，A组（42例），PTCD术中行XperCT检查；B组（45例），PTCD术中不行XperCT检查。采用t检验、χ²检验，比较两组首次穿刺目标胆管成功率（术前拟穿刺的段级胆管）、成功规避重要器官率（包括肝内肿瘤）、穿刺次数及时间、暴露辐射剂量及术后并发症（出血、胆汁瘘、胰腺炎、感染等）。

两组均穿刺成功，首次穿刺目标胆管成功率：A组达到88%，B组51%，P<0.05有统计学意义；成功规避重要器官率，A组可95%规避，B组78%（1例穿刺肿瘤大出血死亡），P=0.018，差异有统计学意义；穿刺时间及次数，A组（14.02±3.23）s、（1.09±0.29）次，B组（63.20±6.22）s、（1.75±0.90）次。暴露辐射剂量A组（6.21±1.35）mGy、B组（21.33±7.38）mGy，术后并发症（出血、感染，胆汁瘘、胰腺炎等），A组（0.07±0.26）例，B组（0.17±0.38）例，以上A组均优于B组，P<0.05，差异有统计学差异。

XperCT在PTCD中加以应用可以弥补单一透视的不足，指导介入医师实施精确治疗，同时避免严重并发症的发生，最终改善PTCD治疗效果。

To explore the clinical application value by using XperCT technology to improve the accuracy in percutaneous transhepatic biliary drainage (PTCD) of malignant obstructive jaundice.

Eighty-seven cases with malignant obstructive jaundice from October 2018 to October 2019 in our hospital were enrolled.All patients were divided into two groups according to the random number table method. Forty-two cases as Group A were underwent XperCT examination during PTCD. Forty-five cases as Group B had no XperCT examination during PTCD. t test and χ2 test were used to compare the success rate of first puncture of target bile duct (segmental bile duct to be punctured before operation), the rate of successful avoidance of important organs (including intrahepatic tumor), number and time of puncture, radiation exposure dose and postoperative complications (hemorrhage, bile fistula, pancreatitis, infection, etc.) between the two groups.

Both groups were punctured successfully. The success rate of the first puncture of the target bile duct were 88% in group A and 51% in group B with significant difference (P<0.05). The success rate of avoiding important organs were 95% in group A and 78% in group B (1 case died of massive hemorrhage from puncture tumor) with significant difference (P=0.018), the number and time of puncture, radiation dose , postoperative complications (hemorrhage, infection, bile fistula, pancreatitis, etc.) were 14.02±3.23 s, 1.09±0.29 times, 6.21±1.35 mGy, 0.07±0.26, in group A respectively, and 63.20±6.22, 1.75±0.90 times. 21.33±7.38 mGy, 0.17±0.38, in group B respectively, and the group A was superior to group B.

The application of XperCT in PTCD can make up for the deficiency of single fluoroscopy, guide interventional physicians to carry out accurate treatment, avoid the occurrence of serious complications, and ultimately improve the therapeutic effect of PTCD.